The Essence of Senior Residency: A Gateway to Professional Evolution

Dear Editor,

Senior residency (SRship) is a pivotal phase in the journey from a postgraduate to a proficient dermatologist. Pursuing SRship, whether for 1 or 3 years is as valuable as a postgraduate period, as you are laying your foundation for a future career. This phase is your opportunity to acquire experience and determine if you meet the criteria to venture into academics or begin your independent practice.

The choice between staying at the same institution as your post-graduation (PG) and joining a different one depends on individual preferences. Staying at the same institution has the benefit of a familiar environment, where faculty and mentors are already acquainted with you, facilitating seamless collaboration on ongoing projects or continuing further research on thesis topics from your PG days. However, a new environment can provide a refreshing change and open avenues for diverse experiences. I did my PG from Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, and my faculty not only facilitated a robust academic schedule but also encouraged and guided residents to engage in scholarly writing. During my postgraduate studies, I had the chance to publish articles and present papers at national and international conferences with the guidance of my faculty, and it fuelled my desire to pursue SRship in the same institute.^[1-3]

The advantages of SRship are manifold. For those aspiring to join an academic institution, apart from clinical skills, engaging in activities such as active participation in research and manuscript writing, involvement in dermatopathology and enhancing teaching and mentoring skills are crucial. On the other hand, those eyeing private practice can utilise this time to refine clinical and surgical skills. Attending workshops, performing various dermatosurgery and handling operating theatre (OT) more efficiently are invaluable during this phase. Moreover, our state, national (IADVL) and international dermatology associations provide opportunities for observerships, fellowships and mentorships. These programmes allow you to work and learn directly under experts in the field, further fine-tuning your skills.^[4] For aspiring academic posts, various institutions typically require a minimum of 1 year of SRship experience, whereas certain institutions, particularly those under the central government, mandate a 3-year SRship. Opting for a 3-year SRship offers a significant period to attain stability in professional, financial and personal aspects before stepping into a new career. On the other hand, 1-year requirement may suit those aiming for independent practice, providing ample time to establish their setup for a smoother transition. Hence, choose the path that aligns with your career goals and aspirations.

During SRship, the main focus is on refining your skills in patient care and management by applying the comprehensive knowledge gained during your PG. One notable advantage is maintaining consistent patient follow-ups, which can be challenging during PG due to changing postings and outpatient department (OPD) rooms. This provides a better understanding of handling refractory and challenging cases, fostering discussions with senior faculty and exploring newer treatments.

The SRship programme at my institute spans 3 years, and during this period, SR will be in charge of the ward, OPD, OT and sexually transmitted disease (STD) clinic, which comes in rotation. In the afternoon, we have each day dedicated to special clinics (aesthetics, vitiligo, autoimmune, allergy and leprosy), grand rounds, seminars and journal clubs. Every posting unfolds a new horizon of taking responsibilities, making independent decisions, guiding postgraduates and undergraduates and learning from seniors and faculty. Moreover, ward and OPD postings provided opportunities for me to publish challenging inpatient cases and to conduct observational and interventional studies.^[5-7] We also have a monthly presentation discussing these intricate cases. Furthermore, handling and overseeing OT, STDs and special clinics have all played pivotal roles in enhancing my confidence in independent practice.

Being in academics offers the added advantage of staying updated and having knowledge at your fingertips. SRship is the opportune moment to pursue additional degrees, which include DNB, specialty certificate examination in (SCE) the United Kingdom and UEMS-EBDVD by the European Board.^[8-10] The reduced stress compared to the postgraduate period or an independent practice allows for a more relaxed pursuit of goals, whether obtaining an additional degree or delving into research. Further attending seminars and journal clubs, writing review articles and contributing to book chapters helped me stay updated and also proved beneficial in preparing for these examinations.^[11,12] For those looking to practice abroad, understanding the necessary qualifications and preparing accordingly during this period is paramount.

Active involvement in ongoing research and conducting innovative studies by dedicating some extra time during SRship contribute significantly to building a robust curriculum vitae (CV) and establishing a lasting presence in the field of research. Publications resulting from these efforts provide an edge and enhance eligibility for scholarships offered by dermatology associations.^[13,14] Publications facilitated my selection for national and international scholarships to attend and present at conferences. This included the Marian Duran Fellowship given by the International Society of Dermatology (ISD) for female residents, the Imrich Sarkany Scholarship and Healthcare Professional Scholarship to attend the European academy of dermatology and venereology (EADV) Congress, travel grants to attend and present at the World Congress of Dermatology (WCD) and British Association of Dermatologists (BAD) conference, DERMACON and SARCD scholarships. Also, I got the opportunity to be selected for observerships, including those from the Delhi State branch (Delhi Derma week), a 1-month observership through IADVL and mentorship from ISD (virtual).

Apart from scholarships, study projects gave me the confidence to try newer treatments, a long-term follow-up helped me for a better understanding of how a new drug works, when and how to taper or maintain, for example, tofacitinib in prurigo nodularis, oral contraceptive pills (OCPs) and spironolactone for hormonal acne, sclerosants in pyogenic granuloma, methotrexate, leflunomide and tofacitinib for alopecia areata, management and counselling of chronic telogen effluvium and Q switched NdYag laser in onychomycosis were some of the projects that I worked on during my SRship.

In personal life, the SRship period often becomes a significant chapter for many, marked by the pursuit of life partners and the joy of starting a family. SRship in dermatology uniquely offers an ideal balance between professional responsibilities and personal aspirations, providing ample space to savour each precious moment in both realms. It is a time to forge meaningful connections and create lasting memories, thanks to the work-life equilibrium SRship brings.

In conclusion, SRship is not just a transition period; it is a pivotal moment for self-reflection and strategic career planning. It is a transformative phase that allows us to shape our destiny and excel in our chosen path.